Internal medicine journal
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Internal medicine journal · Dec 2021
Associations between socioeconomic status and place of residence with survival after aneurysmal subarachnoid haemorrhage.
This study aims to understand early (<24 h post ictus) and late (up to 12 months) survival post aneurysmal subarachnoid haemorrhage (aSAH), with a focus on rurality and socioeconomic status. ⋯ We found high early death in this population-based aSAH Australian population. Survival to 12 months after aSAH was not related to either geographical location or socioeconomic status but modifiable risk factors increased the risk of death.
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Internal medicine journal · Dec 2021
Critical peptic ulcer bleeding requiring massive blood transfusion: outcomes of 270 cases.
Critical peptic ulcer bleeding requiring massive transfusion is a gastroenterological emergency. Few data exist on management and outcomes. The Australian and New Zealand Massive Transfusion Registry collects comprehensive data on adult patients receiving massive transfusion across all bleeding contexts. ⋯ One in five patients with critical peptic ulcer bleeding requiring massive transfusion died by 30 days. Mortality was associated with patient characteristics rather than clinical interventions (e.g. procedures, blood product transfusion).
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Internal medicine journal · Dec 2021
Utilization of telehealth for outpatient diabetes management during COVID-19 pandemic: how did the patients fare?
During the Coronavirus disease 2019 (COVID-19) pandemic, many outpatient services at public hospitals, including diabetes services, had adopted telehealth appointments for their clinic patients. There was concern that patients' glycaemic control may worsen during the pandemic. ⋯ The present study showed that for patients with diabetes who received care via telehealth consultations during the COVID-19 lockdown, their glycaemic control was slightly better, and unplanned admission rates were not higher compared with those in the pre-COVID-19 period. Telehealth consultation offers an important care delivery option in the management of patients with diabetes under these circumstances.
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Internal medicine journal · Dec 2021
Developments in systemic therapies for the management of lung cancer.
Lung cancer accounts for approximately 1 in 10 new cancer diagnoses annually and is responsible for the most cancer-associated deaths in Australia. Despite such figures, there is reason for optimism with many practice-changing developments to report for the management of patients with thoracic malignancies over the last few years. We outline such changes, including the emerging role of immunotherapy in the neoadjuvant and adjuvant setting for patients with localised non-small-cell lung cancer, as well as the established standard of consolidation immunotherapy following definitive chemoradiotherapy for those with locally advanced disease. ⋯ Even among patients with small-cell lung cancer, who account for the worst prognoses and until recently have received a chemotherapy regimen that has remained unchanged in over 20 years, there is a new standard-of-care in combination chemotherapy-immunotherapy. Furthermore, immunotherapy and potentially anti-vascular endothelial growth factor agents now also play a role in mesothelioma treatment. Last, given recent developments in immunotherapy, targeted therapy and combination approaches in the non-small-cell lung cancer space, there is an increasing recognition of the diversity of lived experience for such patients and need for survivorship programmes to acknowledge such nuances.